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Thunderstorm asthma

December 8, 2017

BY DR RICHARD KIDD, CHAIR, AMA COUNCIL OF GENERAL PRACTICE

With then end of the year fast approaching, there are many joys that this time of year brings, but also many hazards. One such hazard is increased risk of thunderstorm asthma. It is now just over a year since the disastrous thunderstorm in Victoria that triggered a mass asthma emergency, with 8,500 people requiring hospital care and ten sadly losing their lives.

While Victorian hospitals featured prominently in the Victorian response, we also know that many patients accessed GP care and advice, including through after hours GP services.

Research is being conducted to better understand why epidemic thunderstorm asthma events occur. It is believed that grass pollens swept up into the clouds as a storm forms, absorb moisture and then burst open filling the air with small allergen particles. Unlike the larger grass pollen grains that cause hay fever, these particles are small enough to be drawn deep into the lungs. The irritation caused resulting in swelling, narrowing and additional production of mucus in the small airways of the lung, making it very difficult to breath.

Symptoms are quick to come on and typically involve wheezing, chest tightness and coughing, much like asthma.

As GPs, it important to be aware that it is not just people with asthma or a history of asthma that are susceptible to a thunderstorm asthma event. Anyone who suffers seasonal hay fever is also at risk. It is important that our at-risk patients understand this and know how to minimise their risks and manage any symptoms if they experience epidemic thunderstorm asthma.

Thunderstorm asthma is now recognised as a serious health threat and over the last year a range of resources have been made available to GPs to assist them in preparing their patients for the grass pollen season and any epidemic thunderstorm asthma event.

GPs should make sure they are up to date with the recommendations in the Australian Asthma Handbook and can undertake the free NPS Medicinewise Clinical E-Audit Asthma Management – supporting patients to achieve good control.This tool will help you improve the individual management of your patients by identifying risk factors, reviewing asthma control, adjusting management and reinforcing the benefits of maintaining an up-to-date written asthma action plan.

The National Asthma Council Australia has also made available a range of resources for GPs and other healthcare professionals in the event of another thunderstorm asthma event, which can be accessed here. These include information papers on epidemic thunderstorm asthma and managing allergic rhinitis in people with asthma and advice on preventative treatment.

In addition, the Asthma Australia website also contains general information about asthma which may be of use to GPs, including how to prepare for and respond to an asthma emergency. They also have specific resources for health professionals.

The key is ensuring at-risk patients understand the risks, know how to reduce them, and have an action plan for responding to symptoms.

This will be my last column for 2017, with the year seeming to go very quickly due to the never-ending advocacy of the AMA on GP issues. On behalf of the Council of General Practice I will take this opportunity to wish you all a safe and happy time with family and friends over the holidays.